During the month of January two insurance carriers, CareFirst Blue Cross Blue Shield and Kaiser Permanente of the Mid-Atlantic, will accept applications for children under the age of 19. This is one of two scheduled open enrollments that allow application for coverage in 2013. The other occurs in July. New policies for children are unavailable at any other time, at least until health reform changes teh rules in 2014.

Policies are available on a guaranteed issue basis without exclusion for pre-existing conditions. The effective date for those who apply in January is February 1st. The effective date for those who apply in July is August 1st.

Health insurance is often provided through employer based coverage, and employers typically subsidize employee premiums. But as healthcare costs continue to rise, trends show employer subsidies for family and dependent coverage continue to decline.

If you have family coverage through your employer you may want to look at the cost to provide separate coverage for your children. Often the total premium of separate policies is lower than that of one family policy offered at work. Here are the reasons. Fewer employers subsidize family premiums and employer plans are usually rated based upon the demographics of the group participants, where employee ages can have a large impact. Rating for child policies are based on the child’s age, which is lower age than the ages of employees in an employer plan. This means child policies are almost always lower cost.

The same strategy can be applied to spouse plans too, but the rate differences amay not be as attractive, and medical underwriting applies for adults.

Whether separating a child or spouse policy will lower your monthly cost depends upon the level of employer subsidy. It’s easy to determine however. Just bookmark this page and run the rate sets for Maryland’s available child plans after January 1st. Rates for spouse plans are available now. It’s free and only takes a minute.

You might think the goal of health reform is to make healthcare more affordable. The bill after all is called the Patient Protection andAffordable Care Act.

Well the truth is this. Affordability is a key component. But sadly for many of us who already have health insurance, we won’t reap the benefit of lower costs. Premiums will rise for many of us to offset the massive costs of federal subsidies designed to help the uninsured, as well as many currently insured, pay for coverage. But subsidies must be paid for.

Back in 2009 when the politic debate raged over the legislation, Congress and the Administration realized the public would never support sweeping taxes on individuals to finance the bill. So instead they raised taxes on the large healthcare corporations that, they argued, could more easily absorb the costs.

Well, let’s take a look at a few financing mechanisms that begin between in 2013 and 2014 and consider how these requirements will assist in the goal of affordability.

1) Big Pharma will be required to kick in between $2.3 to $4.8 billion from the profits they receive from selling brand name prescriptions. Let us not forget that U.S. pharmacy companies reap the benefit of U.S. laws that allow them to sell the same drugs to U.S. citizens at costs far above the costs they sell to citizens of other countries. One can certainly argue they should pay the price for those protections. However, the simple truth is that higher taxes on pharmaceuticals results in higher costs to health insurance carriers that pay claims. Premiums will rise to cover.

2) Medical device manufacturers will be charged a new 2.3% tax on the products they make. So add 2.3% to the cost for things like crutches, braces, and titanium joint replacements, also items like tongue depressors and latex gloves. Premiums will rise to cover.

3) Health insurance companies will be required to pay a new Comparative Effectiveness Research Fee. This is a relatively inexpensive fee, first payable as of July 2013 that is designed to fund studies to determine which types of procedures and treatments perform better than others. Insurance carriers will pay just one dollar per participant per year to start. The fee increases to two dollars per participant in year two and then indexes to medical inflation after that. The fee is set to expire in 2019. This of course assumes that a tax intended to end actually ends. Although relatively inexpensive, it adds cost. Premiums will rise to cover.

4) Health insurance companies will be required to pay a new health insurance industry fee. Fees are estimated to be between 2 to 2.5% of premiums beginning in 2014, rising to 3 to 4% of premiums in later years. Premiums will rise to cover.

5) Health insurance companies will be required to pay a reinsurance assessment fee. This is which is estimated to cost between $60 to $90 per participant per year in 2014, $40 to $60 in 2015, and $25-$35 in 2016. Premiums will rise to cover.

Affordability in the Affordable Care Act is going to be tough to achieve. We’ll have to hope for patient protection.

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